Editorial: The mission: ensure a steady drug supply

A report jointly released this week by Quebec’s College of Physicians and three groups representing Quebec pharmacists should spur governments, both federal and provincial, to hasten the formulation of a national strategy designed to assure a consistent supply of medically necessary drugs.

Shortages of such drugs began to be felt sporadically in 2006 and have become increasingly chronic in succeeding years. According to the province’s pharmaceutical research unit, shortages of some 400 drugs were recorded in 2007. The total was slightly higher the following year, and was more than 600 in 2009.

The problem came to a head last month when the combination of a production slowdown and a fire at the plant of drug-manufacturer Sandoz Canada Inc. in Boucherville resulted in a near-panic in the medical community. The plant produced 90 per cent of the injectable medicines used in Canadian hospitals, including narcotic painkillers, anti-coagulants, sedatives and medicines used in chemotherapy.

Production was slowed following a warning to the firm by the U.S. Food and Drug Administration to upgrade its quality control, and it was entirely disrupted for a time by the fire on March 4. A catastrophe was barely avoided, according to College of Physicians head Dr. Charles Bernard.

This week’s report spotlights the absence in this country of rules that are in force elsewhere, notably in France and the U.S., requiring drug-manufacturers to give immediate notice of any impending slowdown or discontinuation in the production of vital medications. Also deplored in the report was a lack of requirements for firms producing such drugs to maintain production until an alternative source of supply is found in cases where the firms want to discontinue production for reasons of lack of profitability.

The lack of a notification rule was a highlight in the Sandoz case. The firm got the FDA notification of its quality-control problem last November but did not notify health authorities that production would be affected until late February. This week’s report noted that notification requirements in the U.S. prevented close to 200 shortages last year and close to 20 in the first two months of this year.

The report includes a number of recommendations upon which governments should act in fairly short order to bring Canadian drug policy up to a first-class standard:

Joint action by the federal and provincial governments to establish a national action plan to ensure access to vital medications.

Requiring pharmaceutical manufacturers to obtain Health Canada approval before halting production of drugs deemed to be vital.

The implementation of programs on the federal and provincial levels to provide incentives for the continued production of vital drugs that firms might want to discontinue because they are becoming less profitable.

French law can serve as a model in this respect. In that country, manufacturers must give a year’s notice of the permanent discontinuation of a drug deemed medically necessary, and even at that they must wait for approval from government authorities before halting production.

Another problem is an excessive reliance on sole-source providers for particular drugs. This leaves health systems more vulnerable to production slowdowns or catastrophic events such as the Sandoz fire, and tends to kill off competition. Diversification of supply is to be encouraged as much as possible.

It is true that prescription-drug manufacturers are private enterprises, but they are responsible for meeting a critical public need. They must be held responsible for assuring a reliable supply of the medications that are necessary for keeping people alive and healthy.

What is not needed is finger-pointing and jurisdictional quibbling. This was the case in the wake of the Sandoz incident, when the prime minister blamed the provinces for over-reliance on sole-source supplies of vital medications and the national health minister suggested that the drug supply is strictly a provincial responsibility.

It is, in fact, a problem of national scope and demands concerted action by all levels of government. A hopeful sign is that more recently members of Parliament supported an opposition motion calling for just such action, although Parliament has so far stopped short of committing itself to legislate on it.

As recommended by the Quebec report, that commitment should be forthcoming in short order.

Comments

We encourage all readers to share their views on our articles and blog posts. We are committed to maintaining a lively but civil forum for discussion, so we ask you to avoid personal attacks, and please keep your comments relevant and respectful. If you encounter a comment that is abusive, click the "X" in the upper right corner of the comment box to report spam or abuse. We are using Facebook commenting. Visit our FAQ page for more information.

Almost Done!

Postmedia wants to improve your reading experience as well as share the best deals and promotions from our advertisers with you. The information below will be used to optimize the content and make ads across the network more relevant to you. You can always change the information you share with us by editing your profile.

By clicking "Create Account", I hearby grant permission to Postmedia to use my account information to create my account.

I also accept and agree to be bound by Postmedia's Terms and Conditions with respect to my use of the Site and I have read and understand Postmedia's Privacy Statement. I consent to the collection, use, maintenance, and disclosure of my information in accordance with the Postmedia's Privacy Policy.

Postmedia wants to improve your reading experience as well as share the best deals and promotions from our advertisers with you. The information below will be used to optimize the content and make ads across the network more relevant to you. You can always change the information you share with us by editing your profile.

By clicking "Create Account", I hearby grant permission to Postmedia to use my account information to create my account.

I also accept and agree to be bound by Postmedia's Terms and Conditions with respect to my use of the Site and I have read and understand Postmedia's Privacy Statement. I consent to the collection, use, maintenance, and disclosure of my information in accordance with the Postmedia's Privacy Policy.